Nevin Manimala

J Med Internet Res. 2025 Jan 27;27:e58656. doi: 10.2196/58656.

ABSTRACT

BACKGROUND: The COVID-19 pandemic reshaped social dynamics, fostering reliance on social media for information, connection, and collective sense-making. Understanding how citizens navigate a global health crisis in varying cultural and economic contexts is crucial for effective crisis communication.

OBJECTIVE: This study examines the evolution of citizen collective sense-making during the COVID-19 pandemic by analyzing social media discourse across Italy, the United Kingdom, and Egypt, representing diverse economic and cultural contexts.

METHODS: A total of 755,215 social media posts from X (formerly Twitter) were collected across 3 time periods: the virus’ emergence (February 15 to March 31, 2020), strict lockdown (April 1 to May 30, 2020), and the vaccine rollout (December 1, 2020 to January 15, 2021). In total, 284,512 posts from Italy, 261,978 posts from the United Kingdom, and 209,725 posts from Egypt were analyzed using the latent Dirichlet allocation algorithm to identify key thematic topics and track shifts in discourse across time and regions.

RESULTS: The analysis revealed significant regional and temporal differences in collective sense-making during the pandemic. In Italy and the United Kingdom, public discourse prominently addressed pragmatic health care measures and government interventions, reflecting higher institutional trust. By contrast, discussions in Egypt were more focused on religious and political themes, highlighting skepticism toward governmental capacity and reliance on alternative frameworks for understanding the crisis. Over time, all 3 countries displayed a shift in discourse toward vaccine-related topics during the later phase of the pandemic, highlighting its global significance. Misinformation emerged as a recurrent theme across regions, demonstrating the need for proactive measures to ensure accurate information dissemination. These findings emphasize the role of cultural, economic, and institutional factors in shaping public responses during health crises.

CONCLUSIONS: Crisis communication is influenced by cultural, economic, and institutional contexts, as evidenced by regional variations in citizen engagement. Transparent and culturally adaptive communication strategies are essential to combat misinformation and build public trust. This study highlights the importance of tailoring crisis responses to local contexts to improve compliance and collective resilience.

PMID:39869893 | DOI:10.2196/58656

J Med Internet Res. 2025 Jan 27;27:e64649. doi: 10.2196/64649.

ABSTRACT

BACKGROUND: Uncertainty in the diagnosis of lung nodules is a challenge for both patients and physicians. Artificial intelligence (AI) systems are increasingly being integrated into medical imaging to assist diagnostic procedures. However, the accuracy of AI systems in identifying and measuring lung nodules on chest computed tomography (CT) scans remains unclear, which requires further evaluation.

OBJECTIVE: This study aimed to evaluate the impact of an AI-assisted diagnostic system on the diagnostic efficiency of radiologists. It specifically examined the report modification rates and missed and misdiagnosed rates of junior radiologists with and without AI assistance.

METHODS: We obtained effective data from 12,889 patients in 2 tertiary hospitals in Beijing before and after the implementation of the AI system, covering the period from April 2018 to March 2022. Diagnostic reports written by both junior and senior radiologists were included in each case. Using reports by senior radiologists as a reference, we compared the modification rates of reports written by junior radiologists with and without AI assistance. We further evaluated alterations in lung nodule detection capability over 3 years after the integration of the AI system. Evaluation metrics of this study include lung nodule detection rate, accuracy, false negative rate, false positive rate, and positive predictive value. The statistical analyses included descriptive statistics and chi-square, Cochran-Armitage, and Mann-Kendall tests.

RESULTS: The AI system was implemented in Beijing Anzhen Hospital (Hospital A) in January 2019 and Tsinghua Changgung Hospital (Hospital C) in June 2021. The modification rate of diagnostic reports in the detection of lung nodules increased from 4.73% to 7.23% (χ²₁=12.15; P<.001) at Hospital A. In terms of lung nodule detection rates postimplementation, Hospital C increased from 46.19% to 53.45% (χ²₁=25.48; P<.001) and Hospital A increased from 39.29% to 55.22% (χ²₁=122.55; P<.001). At Hospital A, the false negative rate decreased from 8.4% to 5.16% (χ²₁=9.85; P=.002), while the false positive rate increased from 2.36% to 9.77% (χ²₁=53.48; P<.001). The detection accuracy demonstrated a decrease from 93.33% to 92.23% for Hospital A and from 95.27% to 92.77% for Hospital C. Regarding the changes in lung nodule detection capability over a 3-year period following the integration of the AI system, the detection rates for lung nodules exhibited a modest increase from 54.6% to 55.84%, while the overall accuracy demonstrated a slight improvement from 92.79% to 93.92%.

CONCLUSIONS: The AI system enhanced lung nodule detection, offering the possibility of earlier disease identification and timely intervention. Nevertheless, the initial reduction in accuracy underscores the need for standardized diagnostic criteria and comprehensive training for radiologists to maximize the effectiveness of AI-enabled diagnostic systems.

PMID:39869890 | DOI:10.2196/64649

Acta Orthop Belg. 2024 Dec;90(4):745-758. doi: 10.52628/90.4.12611.

ABSTRACT

Chondrosarcomas are the second most common primary bone sarcoma. Due to chondrosarcomas relative resistance to chemotherapy and radiation, surgical treatment has become the mainstay treatment option. The purpose of our study was to understand the proportion of patients in this population who undergo non-operative treatment options secondary to various reasons and analyze the difference in survival as well as patient and cancer specific characteristics between the two groups. We retrospectively reviewed the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with primary chondrosarcoma from 1973 to 2015. We evaluated the patients for both descriptive characteristics as well as cancer specific characteristics. We then performed a propensity matched analysis and other analyses to compare difference in cancer characteristics as well as survival. There were 3048 patients with chondrosarcoma of the bone during our study period of which 188(6.2%) patients did not undergo operative treatment either due to refusal of cancer directed surgery or contraindicated to surgery. A one unit increase in age was significantly associated with increased odds of not undergoing surgery(Odds Ratio 1.04;95% CI, 1.03- 1.05). No statistically significant difference(P = 0.9) in survival was noted between patients with long bone, grade 1 chondrosarcomas regardless of if they did or did not undergo operative treatment. This study provides data to inform the patient on their decisions for or against surgery and may assist the surgeons in counseling patients regarding the surgical treatment of chondrosarcomas. Patients not undergoing operative treatment for chondrosarcomas are at statistically significantly increased risk of mortality.

PMID:39869879 | DOI:10.52628/90.4.12611

Acta Orthop Belg. 2024 Dec;90(4):739-743. doi: 10.52628/90.4.12808.

ABSTRACT

Metastasis stands as one of the most prominent prognostic factors in osteosarcoma. Over 70% of metastatic osteosarcoma occurrences affect the lung. Nonetheless, to date, there has been a scarcity of research addressing predictive factors for lung metastasis risk in osteosarcoma. The objective of this study is to identify the predictive factors that have a role in the risk of lung metastasis in osteosarcoma. This is a retrospective study conducted between January 2018 until January 2023. From the obtained research subjects, an assessment selection was carried out using inclusion and exclusion criteria. Subsequently, preoperative data related to predictive factors will be collected from the research subjects, followed by a clinicopathological conference, chemotherapy, and surgery. Afterward, an evaluation of pulmonary metastasis will be conducted six months after the diagnosis. A total of 47 osteosarcoma patients who met the inclusion and exclusion criteria were analyzed. Bivariate and multivariate logistic regression analyses revealed statistically significant predictive factors for the risk of pulmonary metastasis in osteosarcoma: ALP levels (p=0.014), LDH levels (p=0.038), presence of pathological fractures (p=0.025), and tumor size (p=0.027).

PMID:39869878 | DOI:10.52628/90.4.12808

Acta Orthop Belg. 2024 Dec;90(4):731-737. doi: 10.52628/90.4.10536.

ABSTRACT

Atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLPS) are low-grade, slow-growing, and locally aggressive tumors. We investigated clinical outcomes and recurrence factors for ALT/WDLPS of the extremities. This is retrospective study across three institutions which included patients who underwent surgery for ALT/WDLPS from 2001 to 2019. We collected the data such as the patient demographics, anatomical locations of the tumors (subcutaneous, intramuscular, intermuscular, upper extreme/lower extremity), immunohistochemical data, and the resected margin status. The following variables were evaluated as potential recurrence factors: age, sex, tumor diameter, anatomical location of the tumor, immunohistochemical results, and resected margins. The 5- year local recurrence-free survival rate (RFS) was calculated and differences in survival were assessed. Sixty-two patients were identified, including 29 men and 33 women. The mean age was 63.7 years (range, 34-82 years). The average maximum tumor diameter was 15.9 cm (range, 5-28 cm). The maximum tumor diameter (≥20 cm) was significantly associated with local recurrence (p=0.042). Ten patients (16.1%) developed local recurrence, and the mean time to recurrence was 48.4 months (range, 5-161 months). In our series of 62 patients, the differences in local recurrences were not statistically significant for age, sex, tumor site, surgical margin (R0 or not) and immunohistochemical results. Tumor diameter ≥20 cm, which was the only identified factor for recurrence.

PMID:39869877 | DOI:10.52628/90.4.10536

Acta Orthop Belg. 2024 Dec;90(4):699-707. doi: 10.52628/90.4.12369.

ABSTRACT

Correct treatment of chronic osteomyelitis depends on proper identification of the bone-infecting microorganism, but it is difficult identify the specific etiology in previously treated patients and in those with implants. Small colony variants auxotrophyc for menadione had been related with false-negative results in culture of patient with chronic osteomyelitis, but menadione supplementation can increase bone culture performance. The purpose was to evaluate the effect of menadione supplementation on isolates in bone cultures, in a cohort of patients with osteomyelitis, Medellín- Colombia. We performed a study of a retrospective cohort with 40 adult patients with culture-negative and chronic osteomyelitis, supplemented with 3 doses of menadione. Effect was defined as the proportion of positive bone cultures after treatment administration. The comparison of the effect with clinical variables was made with Chi-square, Fisher and Mann-Whitney U test in SPSS 29.0. Microbiological isolates from bone culture ranged from 0% (pre- treatment) to 62.5% (post-treatment), mainly S. aureus sensitive to methicillin, coagulase-negative Staphylococcus, E. coli and Enterobacter spp. This effect did not present statistical differences according to the clinical characteristics or comorbidities of the patients. We concluded that in patients with chronic osteomyelitis and negative bone cultures, menadione supplementation produces a high proportion of isolates and identification of the etiological agent, which favors correct treatment and reduces readmissions, complications, and resistance to antibiotics.

PMID:39869875 | DOI:10.52628/90.4.12369

Acta Orthop Belg. 2024 Dec;90(4):659-664. doi: 10.52628/90.4.13073.

ABSTRACT

This prospective, observational cohort study compares the clinical and radiographic outcomes of the modified Weaver and Dunn (WD) technique with the newer, anatomical double-button plus tendon allograft technique (DB), and the suture anchor repair plus tendon allograft (SA). The study cohort includes 53 patients, who underwent surgery for acromioclavicular joint (ACJ) dislocation Rockwood type 3, 4 and 5. Patient-reported outcome scores and clinical results, including Disabilities of the Arm, Shoulder and Hand (DASH), the Subjective Shoulder Value (SSV), the Visual Analogue Scale (VAS) and the Constant score (CS) results as well as loss of reduction rates on plain radiographs were compared. Nineteen patients in the DB group, 19 patients in the SA group and 15 patients in the WD group were included. Average time of follow up was 5 years. The mean VAS scores (SD) were 0.3 (0.6), 0.5 (0.8) and 1.2 (1.4) in the WD, DB and SA groups (p=0.06). There were no significant differences in DASH, SSV and Constant scores between groups. Loss of reduction on plain radiographs occurred in 4 patients in total (1 WD, 1 DB, 2 SA). The SSV score, the DASH score, the Constant score and the VAS-score revealed no statistically significant differences between the group with good alignment compared to groups with partial reduction or loss of reduction. In conclusion we can state that the use of anatomical reconstruction techniques with tendon allograft and additional button or suture anchors fixation does not affect the clinical and radiographical outcomes compared to the classic Weaver and Dunn procedure. Loss of reduction was not correlated to worse clinical outcome scores.

PMID:39869870 | DOI:10.52628/90.4.13073

Acta Orthop Belg. 2024 Dec;90(4):575-579. doi: 10.52628/90.4.12752.

ABSTRACT

Dislocation is the second most common indication for revision total hip arthroplasty (THA). In revision cases the dislocation rate can be as high as 5-30%. The aim of this study was to assess the outcome, specifically the dislocation rate in revision THA where a dual mobility cup was used. We retrospectively reviewed all the revision THAs where a dual mobility cup (G7) was used. The pre-operative and post-operative oxford hip scores were recorded. Patients’ electronic records and radiographs were studied for the indications, approaches used, post-operative complications, re-operation rates, and re-revision surgery. Between 2016 and 2020, we performed 59 revision total hip replacements where a dual mobility cup (G7) was used. There were 23 males and 36 females. The average age was 74 years (range, 64-89). Acetabular components were revised in 47 (80%) cases and both the femoral and the acetabular components were revised in 12 (20%) cases. The average follow-up time was 4 years (range, 2-6 years). Average pre-operative and post-operative oxford hip scores were 17 and 36 respectively. The improvement was significant with P value of <.001. Complications were noted in 5 (8%) patients. One patient had dislocation. This patient required re-revision with constrained liner. One patient had intraoperative fracture of the femur and was treated with plate and cables. We conclude that the dual mobility cup can significantly reduce the risk of dislocation when used in revision THA.

PMID:39869859 | DOI:10.52628/90.4.12752

JMIR Public Health Surveill. 2025 Jan 27;11:e59845. doi: 10.2196/59845.

ABSTRACT

BACKGROUND: Numerous studies have assessed the risk of SARS-CoV-2 exposure and infection among health care workers during the pandemic. However, far fewer studies have investigated the impact of SARS-CoV-2 on essential workers in other sectors. Moreover, guidance for maintaining a safely operating workplace in sectors outside of health care remains limited. Workplace surveillance has been recommended by the Centers for Disease Control and Prevention, but few studies have examined the feasibility or effectiveness of this approach.

OBJECTIVE: The objective of this study was to investigate the feasibility and effectiveness of using frequent point-of-care molecular workplace surveillance as an intervention strategy to prevent the spread of SARS-CoV-2 at essential rural workplaces (mining sites) where physical distancing, remote work, and flexible schedules are not possible.

METHODS: In this nonrandomized controlled clinical trial conducted from February 2021, to March 2022, 169 miners in New Mexico (intervention cohort) and 61 miners in Wyoming (control cohort) were enrolled. Investigators performed point-of-care rapid antigen testing on midnasal swabs (NSs) self-collected by intervention miners. Our first outcome was the intervention acceptance rate in the intervention cohort. Our second outcome was the rate of cumulative postbaseline seropositivity to SARS-CoV-2 nucleocapsid protein, which was analyzed in the intervention cohort and compared to the control cohort between baseline and 12 months. The diagnostic accuracy of detecting SARS-CoV-2 using rapid antigen testing on NSs was compared to laboratory-based reverse transcriptase polymerase chain reaction (RT-PCR) on nasopharyngeal swabs (NPSs) in a subset of 68 samples.

RESULTS: Our intervention had a mean acceptance rate of 96.4% (11,413/11,842). The intervention miners exhibited a lower cumulative postbaseline incident seropositivity at 12 months compared to control miners (14/97, 14% vs 17/45, 38%; P=.002). Analysis of SARS-CoV-2 antigen detection in self-administered NSs revealed 100% sensitivity and specificity compared to laboratory-based RT-PCR testing on NPSs.

CONCLUSIONS: Our findings establish frequent point-of-care molecular workplace COVID-19 surveillance as a feasible option for keeping essential rural workplaces open and preventing SARS-CoV-2 spread. These findings extend beyond this study, providing valuable insights for designing interventions to maintain employees’ safety at other essential workplaces during an infectious disease outbreak.

PMID:39869851 | DOI:10.2196/59845

J Urol. 2025 Jan 27:101097JU0000000000004455. doi: 10.1097/JU.0000000000004455. Online ahead of print.

ABSTRACT

PURPOSE: Urinary incontinence (UI) is common in nulliparous female elite athletes, but underlying pathophysiology is inadequately understood. We examined urinary symptoms and associated pelvic floor anatomy and function in this population, hypothesizing that athletes with UI would exhibit pelvic floor findings seen in older incontinent women (e.g., pelvic floor descent and urethral hypermobility) and findings attributable to elite sporting such as muscle hypertrophy.

MATERIALS AND METHODS: We performed a cross-sectional study of NCAA Division 1 nulliparous female athletes comparing symptomatic (i.e. currently or previously experienced urinary leakage during exercise) and asymptomatic athletes. We assessed demographics, sport characteristics, relevant medical history (including Brief Eating Disorder in Athletes Questionnaire) and validated genitourinary symptom questionnaires (Lower Urinary Tract Dysfunction Network Symptom Index-29; Female Genitourinary Pain Index). Pelvic exam and dynamic MRI were used to assess the pelvic floor at rest and at maximal strain. Pelvic floor anatomic structures were evaluated and segmented by MRI.

RESULTS: Of 29 athletes (11 asymptomatic, 18 symptomatic), demographics, sport characteristics, and pelvic exam findings were not statistically different between groups. Symptomatic athletes had significantly worse urinary symptoms (median LURN SI-29 8.5 vs. 8.0, P=0.022) and genitourinary pain (median GUPI 7 vs. 3, P=0.036), greater anterior thickness of the striated urethral sphincter muscle (median 2.5 vs. 1.8 mm, P=0.016) and puborectalis and levator ani muscles (median 10.3 vs. 8.6 mm, P=0.028), and worse disordered eating (median BEDA-Q 7.5 vs. 4.5, P=0.022).

CONCLUSIONS: In nulliparous female elite athletes with UI, dynamic pelvic MRI identified differences in pelvic floor anatomy, which may be part of a multifactorial etiology of UI.

PMID:39869821 | DOI:10.1097/JU.0000000000004455